Health deal should lead to better law

Gov. Tom Corbett and Attorney General Kathleen G. Kane don’t agree on much, but they both deserve credit for working out a deal in Western Pennsylvania that could hold off a loss of access to crucial health care for hundreds of thousands of Pennsylvanians who have insurance.

The pair brokered an agreement between the sprawling University of Pittsburgh Medical System and Highmark, the state’s largest health insurer and one of the largest in the nation. (Highmark and Blue Cross of Northeastern Pennsylvania are in the process of merging.)

The dispute between the companies had its deepest implications in the Western Pennsylvania health care market, but raised broader policy concerns that still should be resolved in favor of consumers statewide.

Highmark acquired the West Penn Allegheny Health System early in 2013. UPMC responded by declaring that, since Highmark had become a competitor for health care delivery, UPMC no longer would be part of the Highmark insurance network. That decision would have left about 1.2 million Highmark subscribers out of network for UPMC’s world-class health care.

The agreement provides for continuity of care for current Highmark subscribers under UPMC care, when the contract expires Jan. 1. It also provides for in-network rates for emergency care and unique care, along with access at some unique locations.

The crisis points to a broader problem. Many Pennsylvanians have health insurance but no guarantee that it provides access to the treatment they need, or the best treatment.

State lawmakers have failed to move a bill that would require all providers to ensure access to all insured consumers. Patients can’t wait for the governor and attorney general to intervene in competitive disputes among insurers and providers. Access should be guaranteed by law.

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